Old Town Endoscopy Center LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

OLD TOWN ENDOSCOPY CENTER LLC

Practice address

5500 Greenville Avenue Suite 1100
Dallas, TX 75206

Phone

(214) 739-9544

Fax

(214) 739-9582

NPI assigned

Feb 7, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Alina Logan

Title

Vice President

Phone

(615) 240-3740

Specialties & licenses 1

Addresses

Other names 1

• Old Town Endoscopy Center Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keiston F Bennett

  • Certified Registered Nurse Anesthetist
  • Fort Worth, TX
  • NPI 1902304017

  Nurse Anesthetist, Certified Registered

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1517961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517961600000",
    "number": "1851890636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1A BURTON HILLS BLVD. ATTN: PROVIDER ENROLLMENT",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156187",
            "telephone_number": "615-922-6102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 GREENVILLE AVENUE SUITE 1100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75206",
            "telephone_number": "214-739-9544",
            "fax_number": "214-739-9582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD TOWN ENDOSCOPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-07",
        "last_updated": "2018-02-07",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "ALINA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "615-240-3740"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Old Town Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deborah M Olay, RPH
• Myrna Dalia Olaya
• Bolanle Basirat Olayiwole, PMHNP
• Madeline Olazaran, FNP-C
• Old Town Endoscopy Center LLC
• Scott Oldebeken, MD
• Frederick E Olden, DDS,MSD,INC
• Stephanie Oldham
• Garrison Daniel Olds, MD
• Jarod Warren Olds, LPC

• Certified Registered Nurse Anesthetist in Dallas, TX
• Providers in Dallas, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.